Provider Demographics
NPI:1124673751
Name:PERRY, CAROLINE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 MORGAN LN
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362-9774
Mailing Address - Country:US
Mailing Address - Phone:361-816-6360
Mailing Address - Fax:
Practice Address - Street 1:1401 W WHEELER AVE
Practice Address - Street 2:
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-4522
Practice Address - Country:US
Practice Address - Phone:361-210-8477
Practice Address - Fax:361-758-7986
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily